Objective: The authors determine whether Massachusetts General Hospital's residency graduates believed their training reflected their current practice activities. Method: The authors surveyed 134 graduates from MGH and MGH-McLean residency classes from 1983 to 2003. Subjects ranked their satisfaction with different components of training on a scale of 1 to 6 and listed areas they wanted emphasized during residency. Results: Sixty-six subjects (49%) returned surveys. Twenty respondents graduated in the 1980s (Cohort 1), 27 in the 1990s (Cohort 2), and 16 in the 2000s (Cohort 3). The most common activities included psychopharmacology, teaching, supervision, research, administration, psychodynamic therapy, and supportive therapy. Least common activities included geriatrics, addiction, and psychoanalysis. Satisfaction with training was high, as was relevance of training. Conclusions: Our graduates from 1983 to 2003 considered residency good preparation for the world of practice and reported that psychopharmacology should be emphasized during training. Respondents expressed a strong desire for continued training in psychodynamic therapy, despite growing emphasis on short-term therapies and biological treatments.